Revision of anterior cervical diskectomy and arthrodesis

ABSTRACT

In this study, eight patients were managed operatively after the failure of an anterior cervical discectomy and arthrodesis. Seven patients had a failure of a previous arthrodesis without deformity [but with different combinations of neck pains, radiculopathy and myelopathy], two of them showed dislodgment of the graft after a Cloward arthrodesis. The last patient showed a failure due to a kyphotic deformity with residual spinal canal compromise after discectomy and a Cloward arthrodesis. Operative revision of the pseudoarthrosis consisted of a repeated resection of the disc space in the area of the failed arthrodesis, followed by repeated anterior Robinson arthrodesis with decompression of the nerve root or the spinal cord. Anterior corpectomy [vertebral body resection] and strut grafting were done for one patient with cervical kyphosis. Revisions were performed from six months to five years after the initial operation. The follow up period after revision ranged from 9-42 months. All reoperated patients got solid fusion of the graft and relief of neck pain with varying degree of neurological recovery